Clinical analysis of 84 cases with retroperitoneal schwannomas

Objective To investigate the diagnosis and treatment of retroperitoneal schwannomas, in order to help clinicians manage this kind of tumor in some unusual locations. Methods From January 3, 1997 to November 20, 2015, clinical data about 84 patients with pathologically proven retroperitoneal schwannomas who were treated in our center were retrospectively analyzed, and the reccurrence, 5-year survival rate and related indexes of these patients were followed up. Results There were 44 females and 40 males with a median age of 45 years (ranging from 23 to 58 years).Forty-three (51.2%) patients with occult onset were diagnosed through health examination, and 41 cases were presented with abdominal discomfort.Computed tomography scanning showed a heterogenous retroperitoneal mass, and a specific 'target sign' was shown in MRI, which might be helpful to diagnosis.Immunohistochemical staining showed positive for S-100, which was a significant criterion for pathological diagnosis.Of the 83 patients undergoing surgery, 73 (88.0%) patients received surgical resections by laparotomic approach, 10 (12.0%) patients by laparoscopic approach (one case was assisted by Da Vinci surgical system). All of the patients with benign tumor had good prognosis with 5-year survival of 100%, while 3 cases with malignancy were not sensitive to chemotherapy with poor prognosis. Conclusion Retroperitoneal schwannoma is a rare tumor with good long-term prognosis. Most of them are quite difficult to diagnose preoperatively, and the main treatment of retroperitoneal schwannoma is surgical excision.